Provider Demographics
NPI:1124167671
Name:MORGAN, WENDELL SCOTT (LPC)
Entity type:Individual
Prefix:
First Name:WENDELL
Middle Name:SCOTT
Last Name:MORGAN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 344
Mailing Address - Street 2:
Mailing Address - City:KINDER
Mailing Address - State:LA
Mailing Address - Zip Code:70648-0344
Mailing Address - Country:US
Mailing Address - Phone:337-789-6150
Mailing Address - Fax:337-639-3008
Practice Address - Street 1:402 INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:OBERLIN
Practice Address - State:LA
Practice Address - Zip Code:70655-3519
Practice Address - Country:US
Practice Address - Phone:337-639-3001
Practice Address - Fax:337-639-3008
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3013101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional